Abstract of Distinction: Mindfulness Interventions and College Student Mental Health: A Systematic Review and Meta-Analysis

Background: University mental health services are increasingly turning to mindfulness programs to help address growing concerns of stress, anxiety and depressive symptoms in college students. Thus, it is critical to systematically evaluate the benefit of mindfulness interventions for improving mental health outcomes in college students, and determine what factors drive successful outcomes.

Methods: The literature search involved multiple electronic databases (inception to 2016). To be eligible, studies used randomized controlled trial (RCT) design, enrolled only college students, involved a mindfulness intervention, and reported mental health outcomes using validated measures. Studies were double-screened for inclusion, and eligible studies were double-coded for key variables. Outcome effect sizes were analyzed as standardized mean differences, adjusted for small samples. Analyses were conducted using inverse-variance weighted mixed-effects meta-regression models.

Results: Fifteen RCTs were identified that reported either anxiety or depressive symptoms, representing 885 participants. The majority of participants were white (67.9%) and female (77.2%). Intervention duration ranged from 1-12 weeks and 12 interventions included a homework component. Six studies only enrolled students with mental health concerns, while the remaining studies recruited from the general student population. Only one study reported monitoring for adverse reactions (no reactions were reported). Compared to inactive control groups, mindfulness interventions were associated with significant reductions in anxiety symptoms (k = 11: ḡ = -0.59, 95% CI [-0.80, -0.39]) and depressive symptoms (k = 11: ḡ = -0.61, 95% CI [-0.90, -0.33]). Compared to active control groups, mindfulness interventions were not associated with significant reductions in anxiety (k = 7: ḡ = -0.15, 95% CI [-0.43, 0.14]) or depressive symptoms (k = 7: ḡ = -0.16, 95% CI [-0.47, 0.15]). Meta-regression analyses indicated that in studies comparing the mindfulness intervention with an inactive control condition, intervention duration (weeks) moderated the effect of the mindfulness intervention on depressive symptoms (b = -0.13, 95% CI [-.20, -0.06]), while type of population sample, provider training, and total minutes of in-person training were not significant moderators.

Conclusion: Mindfulness-based interventions reduced depressive and anxiety symptoms among college students with moderate effect sizes compared to inactive controls. Meta-regression analyses demonstrated that intervention duration was an important moderator with longer interventions reducing depressive symptoms. Methodological concerns, including diversity of subject pool and monitoring for adverse reactions, should be addressed in future studies.